CPR/FIRST AID

Providing First Aid

Immediate care given to the victim of an accident or illness to minimize the effect of injury or illness until experts can take over

Reasons for providing correct first aid

Basic Principles ofProviding First Aid

Remain calm and avoid panic Evaluate situation thoroughly Have a reason for anything you do Treatment you provide will vary

depending on type of injury or illness, environment, others present, equipment or supplies on hand, and availability of medical help

First Steps

Recognize that an emergency exists Use all senses to detect problems Sometimes signs of emergency are

obvious and at other times they are less obvious

Next Steps

Check the scene and make sure it is safe to approach

What to observe If not safe, call for medical help If safe, approach the victim Call emergency medical services

(EMS) as soon as possible

Next Steps(continued)

If possible, obtain the victim’s permission before providing any care

Triage if necessary Check for other injuries Obtain as much information as

possible

General Principles

Obtain qualified help as soon as possible

Avoid any unnecessary movement of the victim

Reassure the victim Use a confident, calm attitude to

help relieve victim’s anxiety Avoid giving the victim anything to

eat or drink

General Principles(continued)

Protect the victim from cold or chilling, but avoid overheating

Work quickly in an organized and efficient manner

Do not make a diagnosis or discuss condition with observers at scene

General Principles(continued)

Maintain confidentiality and protect the victim’s right to privacy while providing treatment

Make every attempt to avoid further injury

Provide only the treatment you are qualified to provide

Performing Cardiopulmonary Resuscitation (CPR)

Cardio: the heart Pulmonary: the lungs Resuscitation: to remove from

apparent death or unconsciousness Breathe for the patient and circulate

blood

Performing Cardiopulmonary

Resuscitation (CPR) (continued) Purpose: keep oxygenated blood

flowing to the brain and other vital body organs

Performed until the heart and lungs start working again or until medical help is available

Clinical Death: when the heart stops beating the victim stops breathing

Biological Death: death of body cells (usually 4-6 minutes after clinical death)

Performing Cardiopulmonary

Resuscitation (CPR) (continued) ABCDs for airway

A stands for airway B stands for breathing C stands for circulation D stands for defibrillation

Performing Cardiopulmonary

Resuscitation (CPR) (continued) Evaluate victim’s condition before

starting CPR Correct hand placement is essential

before compressions are performed Various methods of CPR used

Performing Cardiopulmonary Resuscitation (CPR) (continued)

One-person rescue for adult victim Two-person rescue for adult victim CPR for infants CPR for children CPR for victims with obstructed airways Reasons for stopping CPR

15:3 Providing First Aid for Bleeding and Wounds

Wounds involve injuries to the soft tissues– Open: break in skin or mucous

membranes– Closed: no break in skin or mucous

membranes, but injury occurs to underlying tissues

– Wounds can result in bleeding, infection, and/or tetanus

Classifications of Open Wounds

Abrasion Incision Laceration Puncture Avulsion Amputation

Open Wounds

The most common accidents resulting in open wounds are falls, mishandling of sharp objects, accidents with tools or machinery, and car accidents.

A closed wound (a contusion or internal bleeding) is a bruise that damages the underlying tissue without breaking the skin (as in a black eye).

There are at least five different types of open wounds:

Abrasions An abrasion is a skin wound caused by rubbing or

scraping the skin against a hard, rough surface. Bleeding in this type of wound is usually limited, but it is important that the skin be cleaned in order to guard against infection.

Incisions An incision is a cut caused by a knife, the rough

edge of metal, broken glass, a razor blade or some other sharp object. This type of wound generally bleeds rapidly and heavily. If the cut is deep, muscles, tendons and nerves may be damaged.

Lacerations - A laceration is a jagged, irregular or blunt breaking or tearing of soft tissues, often resulting from mishandling tools and machinery and other accidents. Bleeding from a laceration may be rapid and extensive.

Punctures - A puncture is a piercing wound that causes a small hole in the tissues. Such objects as nails, needles, ice picks and other pointed objects can produce puncture wounds. Even if external bleeding is slight, there may be serious internal bleeding resulting from internal damage to an organ (as in a gunshot wound). All puncture wounds require the attention of a health professional because of the danger of tetanus.

Avulsions - An avulsion is a forcible tearing or partial tearing away of tissues. It occurs in such accidents as gunshot wounds, explosions, animal bites or other body-crushing injuries. Bleeding is heavy and rapid. If a body part (a finger, tooth or toe, for example) has been torn away in an accident, it should always be sent along with the victim to the hospital (placed on moistened gauze and cooled), since there is a possibility that it can be reattached.

When should adolescents and adults get vaccinated against tetanus? Immunization experts recommend that the first dose of Tdap be given at age 11-12 as a booster during the routine adolescent immunization visit if the adolescent has finished the childhood DTaP schedule and has not already received a dose of Td or Tdap.

Adults should continue to receive a booster dose of Td every ten years. Adults who will be having close contact with an infant should receive Tdap vaccine even if they’ve recently received Td vaccine

If someone experiences a deep or puncture wound, or a wound contaminated with dirt, an additional booster dose may be given if the last dose was more than five years ago. It is important to keep an up-to-date record of all immunizations so that repeat doses don't become necessary. Although it is vital to be adequately protected against tetanus, receiving more doses than recommended can lead to increased local reactions, such as painful swelling of the arm.

Who recommends this vaccine?The Centers for Disease Control and Prevention (CDC), the American Academy of Pediatrics (AAP), the American Academy of Family Physicians (AAFP), and the American College of Physicians (ACP) all recommend this vaccine.

Controlling Bleeding

First priority because victim can bleed to death quickly

Bleeding can come from arteries, veins, or capillaries

Observe standard precautions

Controlling Bleeding(continued)

Direct pressure Elevation Pressure bandages Pressure on pressure points Do not disturb clots Do not remove dressings Do not clean wound

Minor Wounds

First priority – prevention of infection Wash your hands before caring for

wound Put on gloves Wash the wound with soap and water Rinse the wound thoroughly Use sterile supplies Tell the victim to get medical help if

any signs of infection appear

Signs of Infection

Swelling Heat Redness Pain Fever Pus Red streaks

Tetanus

Tetanus bacteria can enter an open wound

Serious illness Get tetanus shot or booster as

needed

Objects Embedded in Wound

If superficial, gently remove Objects embedded in tissues should

be left and removed by physician

Closed Wounds

Can occur anywhere on body If bruise, apply cold application to

reduce swelling Observe for signs of internal bleeding Get medical help as quickly as

possible Check breathing and treat for shock Avoid unnecessary movement of

victim No food or fluids

Providing First Aidfor Shock (It’s electrifying!)

Also called hypoperfusion Shock: clinical set of signs and

symptoms that are associated with an inadequate supply of blood to body organs, especially brain and heart

Causes of shock

Providing First Aidfor Shock (continued)

Goals of treatment Positioning of victim Maintain body temperature Avoid food or drink Other principles of care

Signs and Symptomsof Shock

Skin is pale or bluish-gray and cool or cold to the touch

Diaphoresis Rapid and weak pulse Respirations rapid, shallow, and

may be irregular Blood pressure very low or unobtainable

Signs and Symptomsof Shock (continued)

General weakness Anxiety and extreme restlessness Excessive thirst Nausea and/or vomiting Blurred vision or changes in appearance

of eyes

15:5 Providing First Aidfor Poisoning

Can happen to anyone regardless of age

Poison: any substance that causes a harmful reaction when applied or ingested

Immediate action is needed First aid varies depending on

type of poison, injury involved, and the method of contact

Ways Poisoning Occurs

Swallowing various substances Inhaling poisonous gases Injecting substances Contacting the skin with poison

15:6 Providing First Aidfor Burns

Injury caused by fire, heat, chemical agents, radiation, and/or electricity

Classifications of burns– First-degree or superficial– Second-degree or partial-thickness– Third-degree or full-thickness

Treatment Objectives

Remove source of heat Cool the skin Cover the burn Relieve pain Observe for and treat shock Prevent infections

Treatment

Usually not required for first-degree burns

All third-degree burns require treatment

How to treat superficial or mild second-degree burns

How to treat severe second-degree burns and third-degree burns

Providing First Aidfor Heat Exposure

Overexposure to heat may cause a chemical imbalance in the body

Occurs when water and salt are lost through perspiration

Also occurs when body cannot eliminate excess heat

Heat Cramps

Muscle pains and spasms Caused by exposure to heat Loss of water and salt from

perspiration Apply firm pressure on cramped

muscle to provide relief Encourage rest and move to cooler

area Small sips of water or electrolyte

solution (e.g., sports drink)

Heat Exhaustion

Occurs when exposed to heat and there is loss of fluids through sweating

Signs and symptoms First aid care

Heat Stroke

Prolonged exposure to high temperatures

Medical emergency – needs immediate care

Body unable to eliminate excess heat Signs and symptoms First aid care

15:8 Providing First Aidfor Cold Exposure

Exposure to cold external temperatures can cause body tissues to freeze and body processes to slow down

Needs immediate attention Degree of injury affected by wind

velocity, amount of humidity, and length of exposure to cold

Hypothermia

When body temperature is less than 95 degrees Fahrenheit or 35 degrees Celsius

Caused by prolonged exposure to cold

Signs and symptoms Death can occur if body processes

become too slowed down First aid care

Frostbite

Actual freezing of tissue fluids with damage to the skin and underlying tissues

Caused by exposure to freezing or below-freezing temperatures

Early signs and symptoms Other signs and symptoms as

progresses

Frostbite(continued)

Objectives of first aid Common sites: fingers, toes, ears,

nose, cheeks First aid care Assess for signs and symptoms of

shock

Providing First Aidfor Bone and Joint Injuries

Variety of injuries can occur Frequently occur during accidents or

falls Examples: fractures, dislocations,

sprains, and strains May have more than one type of

injury to bones and joints at the same time

Fracture

Break in the bone Closed or simple fracture Compound or open fracture Signs and symptoms Objectives of first aid

Dislocation

When the end of the bone is displaced from a joint or moved out of its normal position within a joint

Tearing or stretching of ligaments, muscles, and other soft tissues also frequently occurs

Signs and symptoms First aid care

Sprain

Injury to the tissues surrounding a joint

Common sites: ankles and wrists Signs and symptoms Frequently resemble fractures or

dislocations – treat as fracture if in doubt

First aid care

Strain

Overstretching of a muscle Caused by overexertion or by lifting Frequent site: back Signs and symptoms First aid treatment

Splints

Devices used to immobilize injured part

Types of splints– Pneumatic or air splints– Padded boards– Traction splints

Splints can also be made from cardboard, newspapers, pillows, boards, etc.

Splints(continued)

Need to be long enough to immobilize the joint above and below the injured area

Should be padded Tied in place Apply as not to create pressure on area If open wound, control bleeding before

applying splint

Splints(continued)

Never attempt to reposition bone Splint before moving victim Observe precautions when using

pneumatic splints Traction splints

Circulation Check After Splint

Verify that the splints are not too tight

Check skin temperature Check color Note swelling or edema Numbness or tingling Check pulse If circulation impaired, immediately

loosen

Slings

Commercial slings Triangular bandages Use: support arm, hand, forearm,

and shoulder Positioning of sling Check circulation Limit movement of limb

Slings(continued)

If use knots– Placement – Padding

Special considerations for shoulder injury

Neck or Spine Injury

Most dangerous types of injuries involving bones and joints

Movement can result in permanent injury resulting in paralysis

Avoid any movement of victim if at all possible

Wait for backboard and adequate help to arrive for transfer

15:10 Providing First Aidfor Specific Injuries

Treatment for burns, bleeding, wounds, poisoning, and fractures is basically the same for all regions of body

Injuries to specific body parts require special care

Examples: eyes, ears, nose, brain, chest, abdomen, and genital organs

Eye Injuries

Always involves danger of vision loss Usually best to avoid giving

major treatment Obtain help of a specialist Foreign objects in the eye Blows to the eye Penetrating injuries that cut eye

tissue

Ear Injuries

Can result in rupture or perforation of eardrum

Torn or detached tissue Ruptured or perforated eardrum Clear fluid or blood-tinged fluid

draining from ear

Brain Injuries

Wounds and blows to head and skull can cause brain injury

Obtain medical help as quickly as possible

Signs and symptoms First aid care

Nose Injuries

Nosebleeds are usually more frightening than serious

Nosebleeds also called epistaxis Causes of nosebleeds First aid care

Chest Injuries

Usually medical emergencies Involve heart, lungs, and major

vessels Sucking chest wound Penetrating injuries to the chest Crushing injuries to the chest

Abdominal Injuries

Can cause damage to internal organs and bleeding in major blood vessels

Intestines and other abdominal organs may protrude from open wound

Medical emergency Bleeding, shock, and damage to

organs can be fatal Signs and symptoms First aid care

Providing First Aidfor Sudden Illness

Can be difficult to determine exact illness

Base care on signs and symptoms Obtain information from victim if

possible Look for medical alert bracelets or

necklaces or medical information cards

Heart Attack

Also called coronary thrombosis, coronary occlusion, or myocardial infarction

Occurs when there is blockage in one or more coronary arteries

If heart stops, start CPR Signs and symptoms First aid care

Fainting

Temporary reduction in supply of blood to brain

Early signs and treatment If victim loses consciousness, try to

prevent injury Obtain medical help if recovery not

prompt, there are other injuries, or fainting reoccurs (can be sign of serious problem)

Diabetes Mellitus

Metabolic disorder caused by lack of or insufficient production of insulin

Diabetic coma Insulin shock

Applying Dressingsand Bandages

Dressings used as sterile covering and to control bleeding

Materials used in dressings Dressings can be held in place with

tape or a bandage Bandages used to hold dressings in

place, to secure splints, and to support and protect body parts

Applying Dressings and Bandages (continued)

Apply bandages snugly enough to control bleeding and prevent movement of dressing, but not so tight that they interfere with circulation

Types of materials for bandages Applying dressings

Checkpoints for Circulation

Check circulation after bandage applied Signs of poor or impaired circulation

– Swelling or edema– Pale or cyanotic color– Coldness to touch– Numbness or tingling– Poor or slow capillary refill

Loosen bandage immediately if warranted

Summary

Proper first aid can save a life Provide only care you are qualified

to provide Always reassure victim and avoid

unnecessary stress and movement Obtain medical help as quickly as possible